Hugh Gainsborough

Hugh Gainsborough was in some ways an unlikely person to be on the staff of a West End hospital in the 1930s. Unmistakably Semitic, he had no time for the affectations sometimes thought necessary for successful private practice. He had a questioning intelligence which refused to accept uncritically the medical dogma of the day, and as a first class scientist he engaged actively in biochemical research, often in association with John Addyman Gardner, the distinguished St George’s biochemist. Not surprisingly his main clinical interests were in disease where laboratory studies had an important role, and particularly in renal disease and diabetes mellitus. He established special diabetic clinics at St George’s and at the London Jewish Hospital, and was one of the first physicians to use insulin in treatment. In spite of his commitment to science, his care for his patients, and particularly for the sick members of the nursing staff, had earned him a high reputation as a sympathetic and widely competent doctor during his time as resident assistant physician at St George’s. It was this quality more than any other which endorsed his election to the staff as assistant physician in 1927.

As a teacher Hugh Gainsborough made little impact on the average undergraduate. He was an appalling formal lecturer and on ward rounds he seemed either ‘too scientific’ or later, as his psychosomatic interests developed, ‘too vague and indecisive’ for those who were looking for the kind of didacticism which would help them to pass their qualifying examinations. His house physicians and registrars gained a truer picture, and learned as much from his insistence on the importance of rather intangible personal and social factors as they did from his critical use of laboratory data.

Always a compassionate doctor, his friendship with Emanuel Miller and his collaboration with Eliot Slater on a survey of psychological factors in gastrointestinal disease encouraged his interest in psychiatry. He cared little for the formal categorization of mental diseases, but immersed himself enthusiastically in psychodynamic concepts with all their implications for diagnosis and treatment. He pursued his beliefs in studies of obesity and chronic bowel disorders.

Hugh Gainsborough’s real influence at St George’s became apparent during the war, when he was senior physician and one of the senior members of the staff remaining at Hyde Park Corner. Together with Hugh Gordon, then acting dean, he strongly supported the view that St George’s should be rebuilt at Tooting instead of at Hyde Park Corner, as had been originally proposed. He had already submitted detailed suggestions for planning that hospital, so that inevitably he became chairman of the medical planning committee which was set up to advise on the ultimately abortive project at Springfield. In conjunction with his architect nephew he put forward a number of new ideas on hospital design, some of which came to fruition when the new hospital was eventually built at Tooting Grove in the 1970s.

Essentially he saw the future St George’s as a district hospital serving a large neighbourhood community, with a medical school having a far stronger academic base than it had had in the past. Ideally he would have liked the hospital to be staffed by whole-time salaried clinicians dividing their time between patient care, teaching and research, instead of engaging in private practice, but he was realistic enough to know that this was unlikely to be immediately possible. He therefore supported the allocation of a substantial number of beds and suitable clinics for private practice, in the hope that it would enable the majority of the staff to be ‘geographically wholetime’.

Hugh Gainsborough’s determination to introduce a clinical academic presence into St George’s first showed itself when he established a twenty-bedded gastroenterological unit at Atkinson Morley’s Hospital, Wimbledon, in 1942, and again in the 1950s when he gave enthusiastic support to the formation of teaching units in medicine and surgery, with part-time directors but with at least one whole-time teacher at lecturer or senior lecturer level in each. In spite of some opposition from other members of the staff who feared, correctly enough, that they would lead in the fairly near future to the establishment of professorships for which Hugh would almost certainly have a candidate in mind, the units came into being. Hugh himself became part-time director in medicine. Too honest to be devious, it was usually obvious that all his projects had some secondary objective dear to his heart. Normally this was to secure a job for one of his protégés. With a ready sympathy and keen, perhaps over keen, eye for the underdog he would give unstinted (and sometimes unjustified) support to those he thought likely to be ‘discriminated against’ because of their race or their sex. It was a mark of his standing among his colleagues that so many of them accepted this foible with tolerant good humour.

As senior physician, Hugh Gainsborough organized regular meetings, often over dinner, with his fellow physicians. Discussions on these occasions were uninhibited and often ranged far beyond their ostensible purpose, so that the business in hand was sometimes scantily treated or even overlooked, but even those who disagreed with his reputedly ‘leftist’ politics and were sceptical of some of his ideas, learned much from this sensitive and private person. After his retirement, casual meetings with his former colleagues and visits to the College as senior fellow kept him in touch with medicine and with St George’s. A small dinner party to celebrate his 80th birthday enabled most of those he had known and worked with to acknowledge their debt and to demonstrate their affection.

In 1926 Hugh married Maia Pilikowski, who died in 1939. They had no children.